HomeMy WebLinkAbout1981-04-06 Permit, New Water Well #6295Contractor
Address
Cue—► Aua ea U Ad
State License No.
Section No.
Parcel No.
Plat No.
Other Description:
City License No.
City Permit No
S
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
Lot Block
473-7357
Sub ';vision
6295
Date (0 8
I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used,
shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
Water Meter:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
SAC
Fee $
Fee $
Fee $
Fee $
Fee S
Fee $ c2o,
Fee $
State Surtax: Fee S "so
o
Total Amount Paid to City ......... Fee S , To
Code: W)dte•File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt